=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336585629
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME TOUCH HOSPICE AND PALLIATIVE CARE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2013
-----------------------------------------------------
Last Update Date | 05/14/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8632 ARCHIBALD AVE STE 109
-----------------------------------------------------
City | RANCHO CUCAMONGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91730-4664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-346-2700
-----------------------------------------------------
Fax | 909-935-3855
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8632 ARCHIBALD AVE STE 109
-----------------------------------------------------
City | RANCHO CUCAMONGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91730-4665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-346-2700
-----------------------------------------------------
Fax | 909-935-3855
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. MARIA CRISTINA GOTOC
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 909-346-2700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------